We spent Tuesday at the ER and it was hard, so hard. In the almost seven months since Madeline passed, I have carried the pain of losing her inside me, where no one can see it. Often I would wish that it could manifest itself into some sort of physical ailment, something visible so others could see with their own eyes how massive and hideous it is. But, like most pain, it is something that I can only tell people exists – they cannot see it just by looking at me.

Since last week, my neck and shoulders have been getting tighter and more painful. Finally, some physical pain to distract me from the razors of loss I feel every day. At first, the pain was a nice little distraction. My brain couldn’t replay April 7th if the act of merely sitting up stole my breath. But then the pain got worse, and worse, and I finally realized on Tuesday morning that maybe I hadn’t slept on it funny, and maybe something was actually wrong.

Sitting in the chairs behind the curtain in the ER, I couldn’t block out anything. A mother struggled to comfort her sick baby. The woosh of a steroid breathing treatment given by nebulizer to a little boy. An alarm sounding on a monitor. I tried to block it out and focus on my physical ailments. A doctor came and had me go over my medical history. I held my breath and hoped that no one would ask about Madeline. They didn’t. Another doctor asked me to rate my pain on a scale of one to ten. I wanted to ask him what people said was a ten. To me, a ten is watching your child die in front of you. Some shoulder pain isn’t on that scale. But I knew he wanted a measure of the pain he could treat, so I threw out a number that sounded urgent.

And then the pain started to get worse, and breathing became harder for me, and I remember just focusing, trying to get through another minute until I’d get a bed and get to lay down. And then I wouldn’t remember anything until I’d feel Mike tugging on my good arm, my left arm, and I’d hear him stay, “stay awake baby, stay awake.” I stayed awake, I tried, until I got hot and sweaty and the room went gray, and the next thing I knew I was in a bed.

Being in a hospital after losing Maddie doesn’t disturb me the way most people think it will. She was born in a private hospital, was in the NICU at the old hospital, and she died in a third hospital. The ER we went to is in the new hospital and has no bad memories for us, nor does the labor and delivery unit Binky will be delivered in a few floors up. But the sounds are the same. The deliberate pace the staff moves at until a crises starts. Mike and I are practiced at pretending curtains are actually soundproof walls when it comes to keeping patient confidentiality, but nothing could keep out the reminders that bad bad things can happen.

I drifted in and out of consciousness for most of the day. I was stunned when my mom arrived and it was eight pm. Mike made me eat some food and drink some fluids, and I was able to carry on conversations again. But before that, Mike had to step up and make decisions for me and Binky, because even though I could hear what the doctors were saying, I couldn’t retain the information. I was too clouded by pain and grief and memories. And when it came back that it wasn’t the horrible thing it could have been, but instead just more pain no one else could see, I was relieved. I have learned how to manage invisible pain.

When the final ER doctor came for a last examination and discharge and she asked me how old my first daughter is, instead of giving my “her second birthday is next week” misleading answer, I told her that my daughter had died. She told me she was so so sorry and I told her that I knew she was, and I was too.

Then we left the ER, and drove away from a hard hard day that in the scheme of things wasn’t really hard at all.